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This is your one-stop spot

for required forms!

The Forms

Beginning 2015 everything has its form!

VA Form 21-0958

Notice of Disagreement (NOD)

​VA Form 21-534EZ

Application for DIC, Death Pension, 

and/or Accrued Benefits

VA Form 21-526EZ

Disability Service Connection

Secondary Service Connection • Increased Disability Compensation • Temporary Total Disability Rating

 Individual Unemployability

Compensation under 38 U.S.C. 1151

 Special Monthly Compensation 

Specially Adapted Housing/Special Home Adaptation Automobile Allowance/Adaptive Equipment

Benefits Based on a Veteran's Seriously Disabled Child

Proposed VA Form 21-0966

Intent To File a Claim For Compensation, Pension, Survivors Pension, Or Other Benefits

The 21-0966 can't be used until


Change of Address

The VA Claims Intake Centers
These are the places you'll mail

or fax forms and evidence to:

Western Region

Department of Veterans Affairs

PO Box 5235
Janesville, WI  53547-5235
Toll Free FAX Janesville – 844-822-5246

Eastern Region
Department of Veterans Affairs

PO Box 5235
Newnan, GA   30271-0020
Toll Free Fax Newnan – 844-531-7817

File Your Claim On-Line


Disability Benefits Questionnaires (DBQ's) 

List By DBQ Form Name

​​DBQ Provider Instructions


VA Form 4140

VA form 21-686c

"Declaration of Status of Dependents"

VA hospital land price probe unresolved

​A year after two members of Congress asked for an investigation into the appraisal

price of the planned Brownsboro Road VA Medical Center site, there has been

no response and opponents are launching an 11th-hour appeal to

persuade Veterans Affairs officials to pick another site.

Jacksonville VA hospital worst among major facilities in country for wait times

More patients wait 30 days or longer for appointments at the Jacksonville Veterans

Administration Outpatient Clinic than at any other major facility in the country,

according to data the VA began making public on individual clinics in November.

​Vets not impressed with VA reforms

​A group of lawmakers and policy activists called for an overhaul of the way the

Department of Veterans Affairs delivers healthcare Thursday, arguing the VA

should let veterans decide whether to get health care from the private sector.

'American Sniper' Killer Will Appeal

Attorneys for the man who murdered "American Sniper" Chris Kyle and his friend

Chad Littlefield said they will appeal the verdict because their client

Eddie Ray Routh couldn't get a fair trial in a small town.

McDonald Tells Congress VA Will Not Completely Privatize Health Care

Veterans Affairs Department Secretary Bob McDonald told lawmakers on Thursday he has no plans to grow the agency's payroll or bureaucracy, or to completely privatize VA health care.

Available on Amazon

The New Claims Intake Centers (CICs)

Your VA regional office (VARO) is no longer the place to send your claims!

If you are western region, mail claims to;

Department of Veterans Affairs Claims Intake Center

PO Box 5235 Janesville, WI   53547-5235

Better yet, fax it toll free to;
FAX Janesville – 844-822-5246

If you are eastern region, mail claims to;

Department of Veterans Affairs Claims Intake Center

PO Box 5235 Newnan, GA   30271-0020
Even better,

Fax Newnan – 844-531-7817

If you mail claims or evidence, use certified mail only!

For the best service, use the eBenefits site.


VA employee reforms, good or not, could be road map for other agencies

​Miller said he hopes his colleagues use his legislation “as a template to look

into other agencies within the federal government.”

'Realities of war': High school students collecting narratives of Vietnam veterans

​Auburn High School history students are looking beyond the

textbooks to learn about the Vietnam War firsthand.

A Disease Doctors Refuse to See
Chronic Fatigue Syndrome Needs Effective Treatments

​A Closer Look at the “Intent to File a Claim” Process

​Gregory M. Rada

Veterans Law Attorney

​VA’s new “intent to file a claim” process which replaces the current informal claim process

on March 25, 2015. I'll take a closer look at the specifics of the new claims filing

process and how it can determine the effective date of a claim.
An intent to file a claim differs from the informal claim process in two important respects.

First, an intent to file a claim must be submitted in the VA’s designated format.

Second, an intent to file a claim does not need to identify the particular medical condition

on which the claim will ultimately be based. This means a veteran can submit an intent to

file a claim and then research and decide which actual claims to bring. As long as the

claim is completed within 1 year of the intent to file a claim, each medical

condition contained in the final completed claim will be assigned an effective

date equal to the date of submission of the intent to file a claim.

You can submit an intent to file a claim for benefits electronically, orally, or by completing

VA Form 21-0966. To submit an intent to file a claim electronically, you must start and

save an application for benefits in the VA’s electronic claims system

(currently eBenefits). The date the electronic application is first saved then

serves as the effective date of the claim as long as fully completed application

is submitted within 1 year. If not, the date the VA electronically receives

the completed claim will serve as the date of claim.
To submit an intent to file a claim orally, a veteran can call a VA call center or

talk in-person with a designated VA employee. The employee will record the

intent to file a claim on VA Form 21-0966. It’s important to note that VA will only

accept an oral intent to file a claim if the conversation is documented by the VA employee. Thus, it’s important to ask the VA to send you a copy of the VA Form 21-0966.

​Finally, a claimant can submit an intent to file a claim by completing VA Form 21-0966.

This is VA’s new proposed form designed specifically for the intent to file a claim process.

The form has three main components: (1) a checkbox to indicate an intent to file

a claim for compensation, pension, or survivors benefits; (2) a section for

identification information; and (3) a signature and date block.
Overall, the important takeaway is to make sure you submit an intent to file a

claim via one of VA’s approved methods, and then to submit your completed

application within a year of that date. This will ensure an effective

date equivalent to the date you filed your intent to file a claim.

​Gregory M. Rada
Veterans Law Attorney

Northland veteran's fight for VA benefits heads to Washington, D.C.

He proudly served in the army guard in the 1980s.

Probe finds more scheduling issues at Phoenix VA center

An internal Veterans Affairs investigation identified widespread deficiencies within the radiology department at the Phoenix VA hospital, according to a report issued Thursday.

Radiology Scheduling Issues Phoenix VA Health Care System 

​The VA Office of Inspector General Office of Healthcare Inspections conducted a review to

assess the merit of allegations made by an anonymous complainant regarding

appointment scheduling, staffing, and other administrative issues in the

Radiology Department of the Phoenix VA Health Care System (facility). 

Union website blocked by VA’s internet system

​The day after the union representing workers at the Department of Veterans Affairs

St. Petersburg Regional Office used its website to announce plans for a

protest against management, the VA’s internet system blocked access to the site.

VA seeks budget help to beat back backlog of disability claims appeals

​While VA has made a fair amount of progress dealing with its claims backlog, the appeals

backlog has grown over the past year. It stands today at more than 285,000 and it

takes on average more than 1,000 days to settle an appeals case.

Families, leaders angered by revelations in ex-VA director's appeal case

The Department of Veterans Affairs had hoped to mollify members of Congress and the

families of victims of the Legionnaires’ outbreak at the Veterans Affairs

Pittsburgh Healthcare System when it fired former director Terry Wolf last year.